Cervix and cervical problems Flashcards Preview

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Flashcards in Cervix and cervical problems Deck (16):
1

Where does cancer of the cervix spread to? (3)

Parametrium, Uterus, vagina. later bladder and rectum.

2

Describe the epithelium of the cervix. (2)

Endocervix: columnar
Ectocervix: squamous epithelium

The meet at the squamocolumnar junction.

3

What is the transformation zone? (1)

During puberty y and pregnancy, there can be partial eversion of the cervix, and the pH of the vagina causes metapalsia of the columnar epithelium to squamous epithelium. This is the transformation zone.

4

What is an ectropion? (1)

Seen as a red ring around the external os of the cervix. It is caused by eversion of the cervix and can cause PCB and discharge. It is also an area more likely to get infected (Cervicitis).

5

How is an ectropion treated? (1)

Cryotherapy

6

What is a cervical polyp? (1)
What symptoms can it cause? (1)
How is it treated? (1)

Benign tumour of the endocervical epithelium.
Can cause PCB or IMB.
Treat with cryotherapy.

7

What is CIN? (2)

Cervical Intraepithelial Neoplasia.
It is a pre-cancerous histological abnormality of the cervix in which abnormal epithelial cells occupy various degrees of squamous epithelium.

8

What are the grades of CIN? (3)

1 (mild dysplasia): atypical cells in lower 1/3
2 (moderate): atypical cells in lower 2/3
3 (severe): atypical cells throughout epithelium. aka carcinoma in situ

9

What are the strains of HPV most likely to cause cervical cancer? (3)

HPV 13, 18, 31 and 33

10

Describe the current screening in the UK for cervical cancer. (3)

From age 25-49, women are offered 3 yearly cervical smears.
From ages 50-64, women are offered 5 yearly smears.

Under 25 years, abnormal cervical changes are common but risk of carcinoma is low, therefore too many false positives.

11

Riley is a 27 year old female who has undergone her first cervical smear.
The results have come back as mild dyskaryosis.
Why can a cervical smear not identify CIN stage? (1)
What is the next step in management? (1)
If her histology comes back as CIN 2, what is the management? (1)

CIN is a histological diagnosis, a smear only looks are superficial cells picked up by the cytobrush.

The same sample can be used to test for HPV types. If a high risk HPV type is identified then she is sent for colposcopy, if there is no high risk HPV found then she is returned to normal screening.

LLETZ: large loop excision of transformation zone.

12

Name one adverse effect of LLETZ. (1)

Haemorrhage, small increased risk of preterm delivery

13

What is the most common type of cancer seen in cervix? (1)

Squamous cell carcinoma (90%)
Adenocarcinoma (10%)

14

What history may precede a diagnosis of cervical carcinoma? (1)

May be asymptomatic.
Missed smears common.
PCB, IMB, PMB.

15

What is the staging for cervical cancer? (4)

FIGO staging
1. Cervix only (classified by depth of invasion and lateral spread)
2. Upper vagina (A: not parametrium; B: parametrium)
3. Lower vagina, or pelvic wall or ureteric obstruction
4. Bladder or rectum involved.

NB: LN not included in staging for cervical cancer.

16

What is the management for cervical cancer? (1)

Surgery:
stage 1: simple hysterectomy or cone biopsy
stage 2: radical hysterectomy and pelvic lymphadenectomy
Chemo-radiotherapy : especially if LN involved.